82 yo man with a history of prostate Cancer and CKD (baseline Cre 1.4-1.6 presumably post-obstructive) who presented with abdominal pain to an outside hospital where he had an EGD that was notable for a duodenal stricture, and CT scan with severe left sided hydronephrosis with obstruction present at the level of the UVJ suspicious for soft tissue mass concerning for bladder cancer.

Since being admitted he has experienced multiple episodes of emesis and now has respiratory failure secondary to aspiration pneumonia.